职业性慢性轻度二硫化碳中毒劳动者的神经传导速度检测分析

Detection and Analysis of Nerve Conduction Velocity in Workers With Occupational Chronic Mild Carbon Disulfide Poisoning

目的研究职业性慢性轻度二硫化碳(Carbon disulfide,CS_2)中毒劳动者周围神经电生理的改变,为二硫化碳职业中毒早期防护提供客观依据。方法选择2012年1月—2015年11月到我院体检的接触CS_2作业工人170例,检测分析其双侧正中神经、尺神经、腓总神经及胫后神经末端潜伏期(distal motor latency,DML)和运动神经动作电位(motor nerve action potential,MNAP)波幅。结果较正常值,劳动者双侧正中神经、尺神经、腓总神经及胫后神经的DML均延长,MNAP波幅均降低(P<0.05)。经Logistic回归分析,较长的工龄、接触高浓度CS_2是影响周围神经传导的危险因素(P<0.05)。CS_2对神经系统的影响,胫后神经DML延长最显著,上下肢差异无统计学意义(P>0.05);正中神经MNAP波幅降低最明显(P<0.05)。结论长期接触CS_2对周围运动神经有明显损害,电生理损害主要为DML的延长。

Objective To study the electrophysiological changes of workers around occupational chronic mild carbon disulfide （Carbon, disulfide, CS2） poisoning, and to provide an objective basis for the early protection of carbon disulfide occupational poisoning. Methods From January 2012 to November 2015, 170 workers exposed to CS2 in our hospitalwere selected, bilateral median nerve, ulnar nerve, peroneal nerve and posterior tibial nerve latency （distal, motor, latency, DML） and motor nerve action potential （motor, nerve, action, potential, MNAP） amplitudes were detected and analyzed. Results Compared with normal values, both sides of the median nerve, ulnar nerve, peroneal nerve and posterior tibial nerve in the workers were prolonged, and the amplitudes of MNAP in DML decreased （P 〈 0.05）. Through Logistic regression analysis, the longer length of service and exposure to high concentration of CS2 were the risk factors of peripheral nerve conduction （P 〈 0.05）. The effect of CS2 on the nervous system was the most significant, and the difference between the upper and lower limbs was not statistically significant （P 〉 0.05） in the posterior tibial nerve （DML）; The decrease of MNAP amplitude was most obvious in median nerve （P 〈 0.05）. Conclusion Long term exposure to CS2 has obvious damage to the peripheral motor nerve, and the electrophysiological damage is mainly prolonged by DML.